Healthcare Provider Details

I. General information

NPI: 1932031804
Provider Name (Legal Business Name): GRETA FORD CHAAR DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRETA FORD DNP

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 W 6TH ST
LAWRENCE KS
66044-1710
US

IV. Provider business mailing address

1055 WASHINGTON ST
LEAVENWORTH KS
66048-2905
US

V. Phone/Fax

Practice location:
  • Phone: 785-842-4477
  • Fax: 785-842-7433
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-85662-072
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: